| Membership
Application |
 |
If you are not a member, we urge you to become
one. It’s a simple application. You may
download the application in pdf format by clicking
here. (This document requires Adobe ®
Reader ® to download and view. If you do not
have Adobe ® Reader ® you may download
it free.) Please complete the application
and return it by mail or FAX to any of the Local’s
Servicing Offices, or, the Central
Office.
| Grievance
Form |
 |
The State of California Contract Grievance form
(Rev 7/00) is in MS Word format and may be downloaded
by clicking
here. It can be filled out and returned by
mail or FAX to any of the Local’s
Servicing Offices, or, the Central
Office.
In accordance with the new workers' compensation
reform law enacted April 19, 2004, you are allowed
to pre-designate your primary care physician as
your personal physician for your workers' compensation
medical treatment. If you pre-designate your personal
physician and provide notice of that pre-designation
to your employer prior to any injury you will
be allowed to be treated by your personal physician
for any work-related injuries. Pre-designating
your physician does not mean that you will not
receive necessary emergency medical care nor does
it mean that your personal physician will not
be able to refer you to other specialists within
the program in which you are enrolled. If you
do not pre-designate your personal physician your
employer or its workers' compensation insurer
shall have sole control over your medical care
for any work-related injury. A properly completed
pre-designation of physician form should be given
to your employer at the same time you present
your dispatch slip. Separate and distinct pre-designation
of physician forms should be tendered to every
employer to whom you are dispatched. You should
maintain a copy of each fully completed pre-designation
of physician form with your personal records.
You should contact your personal physician in
order to assure that your personal physician agrees
to pre-designation.
The Worker's Comp Doctor Designation form is in
MS Word format and may be downloaded by clicking
here.
|
